Thesis (MScMedSc)-- Stellenbosch University, 2013. / ENGLISH ABSTRACT: Much has been documented about the detrimental effects of adverse lifestyle factor exposure on the body. Exposure to factors, such as cigarette smoke, have proved to not only be a burden on global health and economy, but have also led to growing concerns about effects on systemic functions such as reproduction. The aim of the present study was to determine the effects of in utero and in vitro nicotine exposure on spermatozoal function and the antioxidant enzyme activity and lipid peroxidation (LPO) status of the male reproductive system. A better understanding of this process is necessary to combat the respective burdens of smoking and male infertility and for the prospective development of treatment strategies. Two experimental models were employed: Wistar rats were exposed to nicotine in utero while human and rat spermatozoa were exposed to nicotine in vitro. In utero studies were achieved by selecting healthy pregnant rats and treating them with 1 mg/kg-bodyweight/day nicotine or 1 ml/kg-bodyweight/day 0.85% physiologic saline throughout gestation and lactation. Male rat pups were selected and sacrificed at each of the following age groups (n=6): 42 days, 84 days and 168 days old. The pups were only exposed to the treatment/saline via placental uptake or lactation. Biochemical analyses of the tissue comprised of measurement of LPO and antioxidant enzyme activity. Results indicated a significant association of maternal nicotine exposure to decreased levels of primary antioxidant enzymes in rat testes. Of particular note was the observation that the treatment group, of which each of the respective antioxidant enzyme levels were significantly less than the control group, was the oldest (d168) rat group. In vitro studies were achieved by collecting sperm samples from healthy human donors (n=12), healthy rats (n=6) and obese rats (n=6). Samples were washed and exposed to different concentrations of high levels of nicotine (Control, 0.1mM, 1mM, 5mM, 10mM) in vitro. Semen parameters such as motility, viability and acrosome reaction were monitored at different time points (30min, 60min, 120min, 180min). Results revealed increasing in vitro nicotine concentrations were associated with decreased viability and acrosomal status of human spermatozoa and decreased progressive motility and viability of rat spermatozoa. Obesity was also associated with decreases in progressive motility and viability of rat spermatozoa. These results indicate that the acute in vitro exposure of spermatozoa to high levels of nicotine could adversely affect semen quality and may be an additive factor to the impediment of male fertility. In utero results reveal maternal nicotine exposure adversely affects male fertility in later life and seems to elicit more detrimental effects on the reproductive system than that of direct nicotine exposure to spermatozoa. Obesity also inhibits parameters of male fertility and these effects are exacerbated by nicotine exposure. The authors believe these adverse effects on the reproductive system to be related to an increased activation of leukocytes, excess production in reactive oxygen species (ROS) and consequent onset of oxidative stress (OS). Nevertheless this study agrees with other studies that nicotine exposure may be an additive factor to the impediment of male fertility. / AFRIKAANSE OPSOMMING: Daar is reeds baie bekend oor die moontlik newe effekte vir die liggaam wat met ‘n ongesonde lewenstyl gepaard gaan. Menslike blootstelling aan sulke faktore, soos sigaret rook, is wêreldwyd ‘n las vir gesondheid en ekonomie en het gelei tot geweldige kommer onder navorsers oor die moontlike komplikasies vir liggaamlike funksies soos voortplanting. Die doel van die betrokke projek was om die effekte van in utero en in vivo nikotien blootstelling op die antioksiderende ensiem aktiwiteit en lipied peroksidasie status van reproduktiewe weefsel en die funksionele parameters van spermatozoa te bepaal. ‘n Beter begrip van hierdie proses is noodsaaklik om die las van rook en vetsug teen te werk en vir die moontlike ontwikkeling van behandelingsstrategieë. Twee eksperimentele modelle is ontwerp: Wistar rotte is in utero blootgestel aan nikotien terwyl mens- en rot- spermatosoë ook in vitro aan nikotien blootgestel is. Vir die in utero studie is gesonde dragtige rotte gedurende swangerskap en laktasie met 1 mg/kgliggaamsgewig/ dag nikotien of 1 ml/kg-liggaamsgewig/dag 0.85% fisiologiese soutoplossing behandel. Manlike welpies is gekies en geoffer op elk van die volgende ouderdomme (n=6): 42 dae, 84 dae en 168 dae. Die welpies is slegs aan nikotien blootgestel deur plasentale opname en laktasie. Biochemiese analise van die testikulêre weefsel het ‘n beduidende assosiasie getoon tussen maternale nikotien blootstelling en verminderde vlakke van die primêre antioksiderende ensieme. Die 168 dag oue groep het ‘n merkbare vermindering getoon tussen kontrole en nikotien weefsel vir elk van die antioksiderende ensieme. Vir die in vitro studie is sperm monsters verkry vanaf gesonde mans (n=12), gesonde rotte (n=6) en vet rotte (n=6). Monsters is gewas en in vitro blootgestel aan verskeie hoë vlakke van nikotien (kontrole, 0.1mM, 1mM, 5mM, 10mM). Seminale parameters soos motiliteit, lewensvatbaarheid en akrosoom status is by verskei tydpunte gemeet (30min, 60min, 120min, 180min). Dit blyk dat verhoging in in vitro nikotien konsentrasies verband hou met verlaagde lewensvatbaarheid en akrosoom status van menslike spermatosoë en verlaagde progressiewe motilteit en lewensvatbaarheid van rot spermatosoë. Vetsug is ook geassosieer met verlagings in progressiewe beweeglikheid en lewensvatbaarheid van rot spermatosoë. In utero resultate openbaar dat maternale nikotien blootstelling manlike vrugbaarheid nadelig beïnvloed in latere lewe en blyk dat dit meer van ‘n nadelige uitwerking op die voortplantingstelsel het as dié van direkte nikotien blootstelling aan spermatosoë. In vitro blootstelling van spermatosoë aan hoë vlakke van nikotien, het wel ook semen kwaliteit nadelig beïnvloed. Vetsug inhibeer ook manlike vrugbaarheids parameters en hierdie effek word vererger deur nikotien blootstelling. Die outeure glo dat hierdie nadelige uitwerking op die voortplantingstelsel verband hou met 'n verhoogde aktivering van leukosiete, oortollige produksie van reaktiewe suurstof spesies en die gevolglike aanvang van oksidatiewe stres bevorder. Hierdie studie stem wel ooreen met ander studies wat nikotien blootstelling bestempel as ‘n bydraende faktor tot die struikelblok van manlike onvrugbaarheid. / Harry Crossley Foundation (South Africa)

Pour comprendre comment le cerveau inhibe l'appétit en dépit d'un besoin énergétique, nous avons étudié les mécanismes neuronaux qui sous-tendent l'effet hypophagique induit par la 3,4-N-méthylén édioxyméthamphétamine (MDMA : « ecstasie ») et le stress (immobilisation forcée) car ces facteurs réduisent la faim d'un animal, même s'il est affamé. Nous montrons que la stimulation intracérébrale des récepteurs 5-HT4 de la sérotonine (R5-HT4), ou leur plus forte expression (ectopique, physiologique) dans une aire de la récompense (noyau accumbens : NAc), réduit la faim en augmentant l'action anorexigène d'un peptide de l'addiction : CART. A l'encontre de l'équilibre énergétique, l'effet anorexigène induit par la stimulation des R5-HT4 dans le NAc s'accompagne d'une hyperactivité motrice, souvent décrite chez l'humain souffrant d'anorexie mentale. En supposant qu'un effet récompensant prévaut sur le danger d'un déséquilibre énergétique, nous montrons, qu'effectivement, l'injection d'un antagoniste des R5-HT4 dans le NAc réduit les effets anorexigène, hyperlocomoteur et récompensant de la MDMA. S'il est alors récompensant de se priver d'aliments, une souris surexprimant les R5-HT4 dans le NAc, devrait, après une faible et transitoire restriction alimentaire, continuer à s'auto-priver d'aliments même si l'aliment est fourni ensuite ad libitum. La réponse est positive. En revanche, les R5-HT4 du NAc ne contribuent pas, à priori, à l'hypophagie due au stress. Puisque le système de la récompense est inclut dans celui de la prise de décision contrôlée par le cortex préfrontal médian (CPFm), nous avons supposé que l'effet hypophagique provoqué par le stress utilise les R5-HT4 corticaux. L'injection de traitements nucléiques (siRNA, virus), dans le CPFm de souris sauvages et privées des R5-HT4, montre que seule l'activation des R5-HT4 du CPFm est à l'origine de l'effet hypophagique du stress. Nos résultats suggèrent que [1] le stress active les R5-HT4 du CPFm et réduit la densité du transporteur de capture de la 5-HT, favorisant [2] l'augmentation du taux de la 5-HT extracellulaire dans le noyau d u raphé dorsal d'où, [3] un contrôle inhibiteur de l'activité des neurones 5-HT par le R5-HT1A permettant d'éviter que l'hypophagie ne se prolonge en conduite anorexigène. L'ensemble de nos résultats étayent la possibilité que le réseau neuronal de l'addiction et de la prise de décision de manger après stress inclut celui de la conduite anorexigène, avec jusqu'alors, une contribution évidente des R5-HT4. / To understand how the brain inhibits appetite despite an energy demand, we study the neuronal mechanisms, which underlie the hypophagic effect induced by the 3,4-N-methylenedioxymethamphetamine (MDMA: « Ecstasy ») and stress (forced immobilization) because these factors reduce appetite in animals, even starved. We show that stimulating serotonin 4 receptors (5-HTR4), or their overexpression (ectopic, physiological) in a brain reward area (nucleus accumbens: NAc), reduced hunger in increasing the appetite-suppressant effect of an addiction peptide: CART. Against the energy balance, the appetite-suppressant effect induced by stimulating 5-HTR4 in the NAc comes along with hyperactivity, often described in human suffering from anorexia nervosa. Supposing that a rewarding effect prevails over the danger of an energy imbalance, we show indeed that injecting 5-HTR4 antagonist in the NAc reduced the appetite-suppressant effect, the hyperactivity and the rewarding effect provoked by MDMA. If food deprivation is rewarding, mouse overexpressing 5-HTR4 in the NAc, after a low and transient diet period, should continue to self-imposed food refusal even in the presence of food ad libitum. The answer is positive. In contrast, 5-HTR4 in the NAc does not contribute, à priori, to stress-induced hypophagia. Because the reward system is included in the neuronal network of the decision-making, mainly controlled by the medial prefrontal cortex (mPFC), we postulated that hypophagia following stress uses cortical 5-HTR4. Injecting nucleic treatments (siRNA, virus), in the mPFC of wild-type or 5-HTR4 null mice, shows that only the stimulation of 5-HTR4 in the mPFC sparks off the hypophagic effect of stress. Our results suggest that [1] stress activates 5-HTR4 in the mPFC and reduces density of the 5-HT transporter, promoting [2] increase of the extracellular 5-HT level in the dorsal raphe nucleus and thus [3] an inhibitory control of t he activity of 5-HT neurons by 5-HTR1A allowing to avoid that the period of food restriction persists (anorexia-like behavior). Colectively, our findings support the the neuronal network of addiction and decision-making to eat after stress include the neuronal pathway related to anorexia, with so far, a clear contribution of 5-HTR4.

Les récompenses possèdent plusieurs fonctions importantes, liées au plaisir, à la motivation et à l’apprentissage, qui façonnent notre comportement au quotidien. Il est aujourd’hui bien établi que ces fonctions sont prises en charge par un ensemble de régions cérébrales appelé « système de récompense », dont la perturbation peut générer des comportements inadaptés tels que l’addiction. Néanmoins, toutes les récompenses ne sont pas équivalentes, et il n’y a pas lieu de penser que le cerveau répond de façon identique à chacune d’entre elles. Nous avons testé cette hypothèse à l’aide de l’Imagerie par Résonance Magnétique fonctionnelle (IRMf), en adoptant trois angles d’approche différents. Une première expérience s’est concentrée sur la distinction entre récompenses primaires (i.e. ancestrales et concrètes) et secondaires (i.e. évoluées et abstraites), étudiée ici à travers l’exemple des images érotiques et de l’argent. En plus d’un réseau cérébral activé en commun par ces récompenses, nos résultats ont montré une dissociation au sein du cortex orbitofrontal (OFC), recruté spécifiquement dans sa partie postérieure par les récompenses primaires, et spécifiquement dans sa partie antérieure par les récompenses secondaires. Ce résultat soutient l’idée générale d’un gradient de complexité croissante le long de l’axe postéro-antérieur de l’OFC. Dans la deuxième étude, nous avons comparé, au moyen d’une approche méta-analytique quantitative, les activités cérébrales rapportées dans la littérature en réponse à des gains monétaires, des goûts plaisants et des stimuli érotiques visuels. Les résultats obtenus étayent les conclusions de la première étude, et confirment parallèlement l’existence de réponses cérébrales spécifiques à chaque type de récompense. Enfin, dans la troisième étude, nous nous sommes intéressés au jeu pathologique, en formulant l’hypothèse d’un déséquilibre de la sensibilité aux récompenses monétaires versus non-monétaires. Les résultats obtenus confortent cette prédiction, en suggérant principalement une perturbation du traitement des récompenses non-monétaires dans le striatum ventral des joueurs. Dans l’ensemble, ces résultats apportent un éclairage nouveau sur l’architecture fonctionnelle du système de récompense, à la fois chez des individus sains et des individus joueurs pathologiques / Rewards serve several important behavioural functions related to motivation, pleasure and learning. At the cerebral level, reward processing is thought to rely on a well-defined set of brain regions known as the “reward system”, whose disruption has been linked to maladaptive behaviours such as addiction. However, a wide variety of rewards exists, and there is no reason to think that the brain responds equivalently to all of them. In order to test this assumption, we used functional Magnetic Resonance Imaging (fMRI), with three different perspectives. In a first experiment, we investigated the distinction existing between so-called primary (i.e. primitive and concrete) rewards and secondary (i.e. evolved and abstract) rewards, studied here through the examples of erotic pictures and monetary gains. In addition to a common brain network recruited regardless of reward type, our results revealed a functional dissociation within the orbitofrontal cortex (OFC), whose posterior part responded specifically to primary rewards, while its anterior part responded specifically to secondary rewards. Interestingly, this finding supports the idea of a complexity gradient along the postero-anterior axis of the OFC. In a second study, we used a quantitative meta-analytic approach to compare the brain activations reported in the literature in response to monetary gains, pleasant tastes and erotic pictures. The results are in line with the conclusions drawn from the first experiment, and confirm the existence of reward-type-specific responses in the brain. Finally, we conducted a third study focusing on pathological gambling, and aiming to test the hypothesis of an imbalance in the sensitivity to monetary versus non-monetary rewards. The results bring evidence supporting this view, and essentially demonstrate an impaired processing of non-monetary rewards in the ventral striatum of gamblers. Overall, this work sheds new light on the functional architecture of the reward system, both in healthy subjects and pathological gamblers

anglicky This thesis deals with one of the most important issues of our time. Trying to look for personality structure of individuals dependent on alcohol, psychoactive substances and pathological gamblers. Describes differences in personality structure between the user and the differences between men and women. It is divided into theoretical and practical part. The theoretical part is devoted to the present the accessible knowledge in the field of personality-dependent individuals. The empirical part of the work deals with a research carried out at the pavilions of addictions in a psychiatric hospital Prague Bohnice. In the empirical part of the research hypotheses and set goals that are subsequently evaluated. This thesis provides insight into the personality of addicted individuals and their own research conclusions are largely consistent with findings from the literature.

Title: Application and Verification of a Self-defence Program for Patients in a Psychiatric Hospital Objectives: The aim of this thesis is application of a self-defence program, created in a bachelor thesis, during an addiction treatment in Červený Dvůr, a psychiatric hospital. The thesis surveys the suitability of the educational program during addiction treatment, verification of acquired motoric skills and its possible integration in patients' free time, recommendation of the exercise to friends, and last but not least it surveys a possible interest in the program in other psychiatric hospitals. Methods: There are several methods used in the thesis. Content analysis is used for working with literature, interview is used in the conversation held with the department head and the custodian. Observation is used for watching the participants doing the exercise. Comparing is used for evaluation of the final outputs. Opinion poll is used for finding the asset of the educational program. Basic statistic methods are used for evaluating the answers in the opinion polls. Results: The suitability of the program was confirmed by two department heads in two psychiatric hospitals which are focused on addiction treatment. An interest in follow-up self-defence or martial arts exercise was found out in the...

Ce travail de recherche tend à explorer les différents niveaux de processus psychiques liés aux problématiques d’addiction et de grande précarité, du point de vue de la psychologie clinique et de la psychopathologie. Ce questionnement s’est construit à partir du cadre d’une pratique professionnelle de psychologue clinicien intervenant auprès d’un public précaire.Nous soutenons que loin d’être unilatéralement une conséquence de la vie dans la grande précarité, ni même la cause de la « clochardisation », la symptomatologie addictive dans un tel contexte témoigne du rapport du sujet précaire à son corps, à l’altérité et à l’environnement. Nous tentons donc d’explorer dans cette recherche la multitude de scènes corporelles rencontrées auprès de nos patients, et leur potentialité symbolisante, tandis que l’objet d’addiction se placerait comme un contenant dont le contenu à incorporer permettrait une réactualisation de scènes traumatiques de l’histoire du sujet.Ces écueils de la symbolisation, que le sujet tente d’incorporer pour les revivre et les loger sous forme de sensations sur et dans le corps, seraient issus d’épisodes de décramponnement à l’objet primaire, générant alors des vécus de honte primaire extrêmement douloureux et destructeurs, que nous qualifions de honte essentielle et d’effondrement honteux.Ces considérations nous ont amenés à proposer plusieurs fonctions de l’addiction chez le sujet précaire. Les rituels d’incorporation et l’incorporation - elle-même - se poseraient en alternative à l’émergence de l’auto-réflexivité et de représentations insupportables.Les scènes du corps révélées durant la prise de produit, à travers leurs différentes formes d’expressions, tenteraient de trouver une issue à une situation de deuil inachevé, tandis que l’appareil somatopsychique pourrait momentanément s’éprouver comme unifié et contenant. Ce reflux de l’informe vers la sensorialité et la motricité témoignerait d’un processus plus large tendant à investir le corporel sur le versant mortifère.Nous proposons d’analyser à l’aide des médiations thérapeutiques quatre situations cliniques, permettant de saisir les enjeux psychiques de l’addiction chez les sujets précaires. / This research aims at exploring the different levels of psychic processes related to addiction problems and great precariousness from a clinical and psychopathological point of view. This questioning was built from the professional experience of a clinical psychologist working with precarious and addicted patients.This work contends that, far from being a unilateral consequence of living in great precariousness, and not even the cause of homelessness, addictive symptomatology in such a context illustrates the relationship of the precarious subject with his body, with the otherness and with his environment. This research tries to explore the great variety of corporal scenes encountered among our patients and their symbolizing potentiality while the addictive object would turn into a container whose contained would allow a reactualization of the subject’s traumatic scenes.These symbolization failures that the subject tries to incorporate in order to live them again and turn them into sensations on and inside his body, would stem from sensations felt when breaking away from primary object, thus generating extremely painful experiences of primary shames called essential shame and shameful collapse. These considerations have led us to offer several functions of addiction for precarious subjects. Rituals of incorporation and incorporation itself, could be an alternative against auto-reflexivity and unbearable representations.While taking drugs, the body scenes revealed through their different forms of expression would strive to solve an unfinished mourning situation, while the somatopsychic apparatus could momentarily feel unified and contained.This backward surge of the formless towards sensoriality and motricity would suggest a wider process tending to place the corporeal image on the deadly side With the help of therapeutic mediations, we propose to analyze four clinical situations that will enable us to understand the psychic stakes of addiction for precarious patients.

Bakgrund: Drogberoende patienters upplevda förmåga att hantera sitt drogberoende, antas påverka utfallet av vården. Self-efficacy förmodas spela en framträdande roll, tillsammans med sjuksköterskans förhållningsätt och stöd för denna patientgrupp.     Syfte: Att beskriva self-efficacy och dess roll vid påverkan på patienter med drogberoende.  Metod: Genom litteraturöversikt skapa en kunskapsöversikt över self-efficacys roll och påverkan på drogberoende patienter.   Resultat: Resultatet bekräftar self-efficacy som en viktig faktor, men att andra faktorer verkar självständigt och styrande i sitt förhållande till self-efficacy, i en komplex kontext. Andra viktiga faktorer utöver self-efficacy framkommer i resultatet, är socialt stöd och social kontext, kognitiva faktorer och psykisk hälsa, interventioner och behandling.  Slutsats: Self-efficacy är som faktor viktig och ingår i ett komplext sammanhang med andra faktorer. Self-efficacy framstår som en viktig faktor i sin roll för påverkan på de drogberoende patienterna. I detta sammanhang är sjuksköterskans personcentrerade förhållningssätt viktigt, för att genom ett evidensinformerat arbete sammanföra detta med den nödvändiga kunskapen som patienten har om sig själv och för att så stötta patienten på bästa sätt. Vidare omvårdnadsforskning bör göras på drogberoende patienters olika följdsjukdomar, tidiga interventioner och negativt behandlings utfall, med ett focus på self-efficacy. / Background:  Drug dependent patients perceived ability to deal with where drug addiction, are assumed to influence the outcome of care. Self-efficacy is likely to play a prominent role, together with the nurse's attitude and support for this group of patients.  Purpose:  To describe the role of self-efficacy and its effects on patients with drug dependence.  Method:  Through literature overview create a knowledge overview of self-efficacy’s effect on drug dependent patients.  Results:  The result confirms self-efficacy as an important factor, but other factors seems to be autonomous and self-governing in its relationship with self-efficacy, in a complex context. Other important factors that emerge in the result set in addition to selfefficacy are social support and social context, cognitive factors and mental health, interventions and treatment.  Conclusion:  Self-efficacy is as a factor important and are included in a complex context with other factors. Self-efficacy is emerging as an important factor in his role for the impact on the drug dependent patients. In this context, the nurse's personcentered approach is important, because with an evidence informed work combine this with the necessary knowledge that the patient has about himself and in so support the patient in the best way. Nursing research should be done on various sequelae of drug dependent patients, early interventions and negative treatment outcome, with a focus on self-efficacy.

Huang, Hanyun. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 224-242). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; appendix in Chinese.

過去50年，香港媒體有關藥物成癮的主要概念主要來自對海洛因(俗稱「白粉」)吸毒者的想像。「吸毒者」通常被視為「對工作和家庭不負責任」，並且被描繪成「以犯罪獲得金錢購買毒品來紓緩嚴重的斷癮症狀。」然而，近年來，大部份青少年吸毒者吸食軟性毒品如氯胺酮和搖頭丸，而非海洛因。對青少年吸毒者而言，在道德和醫學概念上的「吸毒」定義並不符合他們的毒品經驗，原因是他們在使用藥物後並無嚴重的斷癮症狀。這種傳統毒品觀念與青少年吸毒者經驗之間的「矛盾」對戒毒和預防教育產生很大障礙。 / 本研究旨在找出現有主流媒體、戒毒機構及青少年吸毒者對「吸毒」的詮釋。本研究首先對禁毒政策進行歷史分析，以找出禁毒政策和現有的道德和醫學毒品論述之間的關係。另外，本研究對1978年至2008年的100個禁毒廣告及由1979年至2009年的26部禁毒電視新聞紀錄片進行文本及論述分析，以整合過去30年來本地媒體所運用的毒品論述。再者，本研究在一所福音戒毒中心（基督教得生團契）及一間社區戒毒輔導中心（香港路德會青欣中心）分別進行14個月及10個月民族誌考察，以檢視社工及青少年吸毒者如何運用主流媒體流行的毒品論述。 / 本研究發現主流媒體經常使用一種包含道德及醫學論述的「過來人」敘事法(go through narrative)。這種敘事法主要以吸毒「過來人」作為關鍵主體，去描述吸毒者最「真實」的「浪子回頭」故事，並且組成了主流的「浪子回頭」論述(Prodigal Son Returns Home Discourse)，為吸毒者建立了一個「浪子」身份。另外，本研究亦發現媒體中常見的「過來人」敘事法亦常被社工及戒毒過來人應用，並將吸毒定性為生活方式問題。青少年吸毒者對主流論述的「浪子」身份表現出不同程度的適應，但這種敘述自我身份的靈活性仍被局限於「過來人」敘事法及其容許的論述原素(discursive components)當中。 / 在理論層面上，本研究歸納出形成社會異類身份的主流論述所涉及的社會、組織、及互動層面的因素。而且，本研究亦歸納出在主流論述控制下，社會異類者體現自我身份自主性的策略，包括：「漠不關心」(Indifference)、「完整接受」(Adoption)、「自我適應」(Adaptation)及「自我肯定」(Affirmation)。透過靈活表述社會異類行為的性質，他們肯定個人身份及對抗主流論述。然而這種敘述自我身份的靈活性仍被局限於主流論述原素當中。 / For over 50 years, the major conception of drug addiction in Hong Kong media comes from the imaginations of heroin addiction. Drug addicts are usually presented as irresponsible for job and family, and they commit crimes to get money to buy drugs in order to relieve serious withdrawal symptoms. However, in recent years, most youth addicts use ‘recreational drugs’ like ketamine and ecstasy rather than heroin. The moral and disease conceptions of drug addiction are not applicable in their drug-taking experiences because many youth psychotropic drug addicts find no severe withdrawal and tolerance symptom. The ‘gap’ between the conventional drug discourses and the experience of youth drug users produces dissonance among addicts, drug rehabilitation and preventive education. / This study aims at figure out the existing meanings of drug addiction in the mass media and drug rehabilitation. Firstly, a historical analysis on the government anti-drug policy was conducted to figure out the relationship between social policy and the moral and medical drug discourses. Secondly, textual analysis on 100 government anti-drug advertisements from 1978 to 2008 and discourse analysis on 26 local TV news documentaries about drug addiction from 1979 to 2009 were conducted to examine the mediated drug discourses. Thirdly, a 14-month ethnographic research in a Christianity drug rehabilitation camp (called the Christian New Being Fellowship) and a 10-month ethnographic research in a local drug rehabilitation-counseling center (called Hong Kong Lutheran Social Service Cheer Centre) have been conducted to reveal the current drug discourses consumed by the social workers and the youth drug addicts. / From the analysis on anti-drug TV advertisements and TV news documentaries, a “go through" narrative is identified which encapsulates the moral and medical drug discourses. Such narrative involves ex-addict as key subject who tells the “authentic" drug story of a “prodigal son". It contributes to a mediated dominant “Prodigal Son Returns Home" discourse that constitutes the ‘prodigal son’ identity of drug addicts. From the ethnographic studies in drug rehabilitation organizations, it is found that the “go through" narrative identified in media functions as an important discursive component for the social workers and professional ex- to present the nature of drug addiction. “Prodigal Son Returns Home" discourse could also be identified in drug rehabilitation, which morally defines drug addiction as personal misconduct and lifestyle problem. However, youth drug addicts adopt the ‘prodigal son’ identity to various extents. But such flexibility is restricted to selecting discursive components of the only available “go through narrative under rehabilitation. / This research makes theoretical contributions by identifying the factors in social, institutional and interactional dimensions that constitute the mediated dominant discourse of deviant identity. Besides, this research shows some tactics of the socially deviant in performing agency under the mediated dominant discourse, which include: “Indifference", “Adoption", “Adaptation", and “Affirmation". Socially deviants may favor their own personal identity and resist the mediated dominant discourse by flexible narration of deviant behavior, which is restricted by the available discursive components of the mediated dominant discourse. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Tsen, Wai Sing. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 516-534). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; some appendixes also in Chinese. / Abstract of thesis entitled --- p.i / Acknowledgements --- p.v / Table of Contents --- p.vi / List of Tables and Figures --- p.xiii / Chapter Chapter 1: --- Introduction --- p.1 / Chapter 1.1 --- The Current Conceptions of Drug Addiction -- 2 Dimensions --- p.2 / Chapter 1.2 --- Current problem of youth drug addiction in Hong Kong -- changing conceptions on drug experiences --- p.4 / Chapter 1.3 --- Challenge to the field: to negotiate a new conception of drug addiction --- p.7 / Chapter 1.4 --- Theoretical Implication: The Question of Mediated Dominant Discourse and Agency of Deviant Identity --- p.9 / Chapter Chapter 2 --- Social Constructionist Approach on Drug Addiction --- p.11 / Chapter 2.1 --- The concepts of ‘Drug Addiction’ --- p.11 / Chapter 2.2 --- Drug Addiction Models --- p.13 / Chapter 2.2.1 --- Moral Model --- p.13 / Chapter 2.2.2 --- Disease Model --- p.14 / Chapter 2.2.3 --- Social Learning Model --- p.15 / Chapter 2.2.4 --- Identity Model --- p.16 / Chapter 2.3 --- Symbolic Interactionism and Identity Transformation --- p.17 / Chapter 2.4 --- Social Construction of Drug Addiction --- p.20 / Chapter 2.5 --- From Behaviorism to Discursive Psychology on Drug addiction --- p.23 / Chapter 2.6 --- Addiction as Social Accomplishment --- p.25 / Chapter 2.7 --- The Myth of Addiction -- A Functional Explanation for Drug Use --- p.29 / Chapter 2.7.1 --- Attribution Bias in Drug Addiction --- p.30 / Chapter 2.7.2 --- The Paradox of ‘Scientific’ Evidence on Drug Addiction --- p.32 / Chapter 2.7.3 --- Drug Addiction as Preferred Explanation --- p.33 / Chapter 2.8 --- Implications -- to Elucidate the Constituted Nature of Drug Addiction --- p.34 / Chapter Chapter 3: --- Symbolic Interactionism on Deviant Identity --- p.38 / Chapter 3.1 --- Sociological Study of the Socially deviants --- p.38 / Chapter 3.2 --- Symbolic Interactionism: the Production of Self as Social Constructs --- p.40 / Chapter 3.3 --- Goffman: Deviant as Social Construction on Social Identity --- p.43 / Chapter 3.4 --- Becker: Deviant as Career on Social Label --- p.46 / Chapter 3.5 --- The Issue of Power and Deviant Identity --- p.49 / Chapter Chapter 4: --- Research Issues and Methodology --- p.52 / Chapter 4.1 --- Discourse Analysis -- the Basic Principles --- p.53 / Chapter 4.2 --- Discourse of Normality and Deviant Discursive Power of Regulations --- p.55 / Chapter 4.3 --- Discourse, Identity and Power --- p.57 / Chapter 4.3.1 --- Constructive Views on Social Identity --- p.57 / Chapter 4.3.2 --- Formation of Drug Addicts in Subject Position --- p.58 / Chapter 4.3.3 --- From Interpellation to Discursive Construction of Subjects --- p.59 / Chapter 4.4 --- Intertextuality in Texts and Mediation -- Study of Narrative and Discourse --- p.64 / Chapter 4.4.1 --- Narrative and Identity --- p.65 / Chapter 4.4.2 --- Narrative of Recovery --- p.68 / Chapter 4.4.3 --- The Structured Narrative of Recovery -- the Story of Professional Ex- --- p.70 / Chapter 4.5 --- Drug Discourses in Institutions Study of Disorders of Discourses --- p.72 / Chapter 4.6 --- Research Issues --- p.73 / Chapter 4.7 --- Research Methods --- p.77 / Chapter Chapter 5: --- Social and Historical Contexts of Drug Addiction in Hong Kong --- p.84 / Chapter 5.1 --- Historical Context of Drug Addiction in Hong Kong --- p.84 / Chapter 5.2 --- The Rise of Heroin Addiction in Hong Kong --- p.87 / Chapter 5.3 --- The Construction of Moral and Disease Conceptions of Drug Addiction --- p.89 / Chapter 5.4 --- Recent Trend of Drug Addiction in Hong Kong --- p.93 / Chapter 5.5 --- Recent Youth Drug Addiction Profile -- the Rise of Psychotropic Substances --- p.96 / Chapter 5.6 --- Youth Attitudes on Drug Addiction --- p.98 / Chapter 5.7 --- The Influence of ‘Rave Culture’ and Psychotropic Drugs Addiction --- p.100 / Chapter 5.8 --- Cross Border Drug Addiction in Youth Community --- p.101 / Chapter 5.9 --- From Recreational Use to Personal Use of Psychotropic Drugs --- p.102 / Chapter Chapter 6: --- Drug Treatment and Rehabilitation in Hong Kong --- p.106 / Chapter 6.1 --- Treatment Goals in Rehabilitation --- p.106 / Chapter 6.2 --- Treatments and Rehabilitation in Hong Kong --- p.108 / Chapter 6.2.1 --- Compulsory Drug Treatment Scheme --- p.109 / Chapter 6.2.2 --- Methadone Treatment Program in Hong Kong --- p.110 / Chapter 6.2.3 --- Voluntary Residential Treatment and Rehabilitation Programs --- p.113 / Chapter 6.2.4 --- Substance Abuse Clinics and Counseling Program for Psychotropic Substance Abusers --- p.115 / Chapter 6.3 --- Christianity Drug Rehabilitation in Hong Kong --- p.115 / Chapter 6.3.1 --- The Early History of Christianity Drug Rehabilitation --- p.117 / Chapter 6.3.2 --- The Important Role of Operation Dawn --- p.120 / Chapter 6.3.3 --- Further Development of Christianity Drug Rehabilitation in 1980s --- p.122 / Chapter 6.4 --- The Rise of Counseling Services for Psychotropic Substances Abusers --- p.124 / Chapter Chapter 7: --- Anti-Drug TV Advertisements -- Construction of Moral Drug Discourse in Hong Kong --- p.126 / Chapter 7.1 --- Paradoxical Linkage between Drug Addiction and Crime --- p.127 / Chapter 7.2 --- The Construction of Moral Conception of Drug Addiction in 1970s --- p.129 / Chapter 7.3 --- New Approach in 1980s the Incoming of Psychotropic Drugs. --- p.133 / Chapter 7.4 --- The Dilution of Moral Conception of Drug Addiction in the 1990s --- p.135 / Chapter 7.5 --- From Lifestyle Appeal to Re-invention of Moral Appeal in 2000s --- p.137 / Chapter 7.6 --- The Change of Moral Conception of Drug Addiction --- p.141 / Chapter Chapter 8: --- Anti-Drug TV News Documentaries -- An Overview --- p.143 / Chapter 8.1 --- Categories and Distributions of TV News Documentaries from 1979-2009 --- p.144 / Chapter 8.2 --- Types of Informants in News Documentaries -- Who can speak? --- p.149 / Chapter 8.3 --- The Image of Drug Addicts in the News Documentaries --- p.154 / Chapter 8.4 --- Reported Types of Drugs Abused in News Documentaries --- p.156 / Chapter 8.5 --- Attributions of Drug Addiction given in News Documentaries --- p.158 / Chapter 8.6 --- Solutions of Drug Addiction in News Documentaries from Personal Misconduct to Societal Responsibility --- p.161 / Chapter 8.7 --- Consequences of Drug Addiction in News Documentaries to Construct Moral and Medical Drug Discourses --- p.164 / Chapter 8.8 --- The Importance of Christianity Drug Rehabilitation as Major Source of Informants in News Documentaries --- p.167 / Chapter 8.9 --- The Preferred Image of Drug Addicts in News Documentaries --- p.169 / Chapter Chapter 9: --- Mediated Drug Discourses in TV News Documentaries --- p.171 / Chapter 9.1 --- Medical Discourse --- p.172 / Chapter 9.1.1 --- Medical Discourse in TV News Documentaries --- p.173 / Chapter 9.1.2 --- Defining Psychotropic Drug Addiction in Medical Discourse --- p.176 / Chapter 9.1.3 --- The Construction of ‘Addictive Substance’ --- p.178 / Chapter 9.2 --- Moral Discourse --- p.182 / Chapter 9.2.1 --- Moral Discourse in TV News Documentaries --- p.183 / Chapter 9.2.2 --- Moral Discourse and Heroin Addiction --- p.185 / Chapter 9.2.3 --- Dominant Role of Moral Drug Discourse --- p.191 / Chapter 9.3 --- Legal Discourse --- p.193 / Chapter 9.3.1 --- Legal Discourse in TV News Documentaries --- p.193 / Chapter 9.3.2 --- Functional Use of Legal Drug Discourse --- p.195 / Chapter 9.4 --- The Dominance of Moral and Medical Drug Discourses --- p.199 / Chapter Chapter 10: --- Prodigal Son Returns Home Discourse Articulation of Drug Addict Identity in Go Through Narrative --- p.202 / Chapter 10.1 --- The ‘Go Through’ Narrative in Life Story Programs about Christianity Drug Rehabilitation --- p.203 / Chapter 10.1.1 --- Subject Positions in Life Story Programs on Christianity Drug Rehabilitation --- p.203 / Chapter 10.1.2 --- Stories by Addict / Ex-addict as Central Component --- p.205 / Chapter 10.1.3 --- The Role of Social Workers / Rehabilitation Practitioners / Relatives --- p.211 / Chapter 10.2 --- The ‘Go Through’ Narrative in Current Affairs Programs --- p.216 / Chapter 10.3 --- Summary: ‘Go Through’ Narrative in TV News Documentaries --- p.222 / Chapter 10.4 --- The Exception Alternatives and Disorders of Discourses --- p.225 / Chapter 10.5 --- The “Prodigal Son Returns Home" Discourse and the Personalization of Drug Problems --- p.228 / Chapter 10.6 --- ‘Prodigal Son Returns Home’ Discourse as Social Practice -- the Zheng Sheng College incident --- p.231 / Chapter 10.7 --- The Mediated Drug Discourses and the Preferred Identity of Drug Addicts --- p.236 / Chapter Chapter 11: --- Christianity Drug Rehabilitation and the Preferred ‘Prodigal Son’ Identity of Drug Addicts --- p.240 / Chapter 11.1 --- About the Field of Study: Christian New Being Fellowship (CNBF) --- p.241 / Chapter 11.1.1 --- Treatment Stages in the CNBF --- p.242 / Chapter 11.1.2 --- Training Programs in the CNBF --- p.243 / Chapter 11.2 --- Research Methods in the Field --- p.244 / Chapter 11.2.1 --- Participant Observation --- p.245 / Chapter 11.2.2 --- In-depth Interviews: the CNBF Trainees --- p.245 / Chapter 11.2.3 --- In-depth Interviews: Ex-addicts Helpers and Social Workers --- p.246 / Chapter 11.3 --- The “Scheduled" Life in CNBF --- p.246 / Chapter 11.4 --- The “Dull" Life in CNBF --- p.249 / Chapter 11.5 --- Ways to Tackle --- p.251 / Chapter 11.6 --- The Preferred “Prodigal Son Returns Home" Discourse in the CNBF --- p.255 / Chapter 11.6.1 --- Presenting the “Love" and “Heal" as Core Message --- p.255 / Chapter 11.6.2 --- Drug Addiction as “Lifestyle Problem" --- p.256 / Chapter 11.6.3 --- Professional ex- as the ‘Role Model’ of Lifestyle Transformation --- p.259 / Chapter 11.6.4 --- The Hitting Bottom Experience as Key to Recovery --- p.260 / Chapter 11.6.5 --- Sin, Heal and the Prodigal Son --- p.261 / Chapter 11.7 --- Oppositional Readings to the “Prodigal Son" Story of Drug Addiction --- p.265 / Chapter 11.7.1 --- The Narration of ‘Withdrawal’ Symptoms --- p.266 / Chapter 11.7.2 --- The Volitional Nature of Recreational Drug Use --- p.267 / Chapter 11.7.3 --- Functional Uses of drugs --- p.268 / Chapter 11.7.4 --- Habitual and ‘Harmless’ Usage of Drugs --- p.270 / Chapter 11.7.5 --- The Evil Heroin Addiction --- p.272 / Chapter 11.8 --- Hardship in Christianity Drug Rehabilitation the Resistance to “Prodigal Son Identity --- p.275 / Chapter Chapter 12: --- Outpatient Drug Counseling Centre The Strategic Use of Prodigal Son Identity --- p.279 / Chapter 12.1 --- The History and Information of Out-patient Drug Counseling Service --- p.281 / Chapter 12.1.1 --- Information about the Field of Study: Cheer Lutheran Centre --- p.282 / Chapter 12.1.2 --- Characteristics of Youth Drug Addicts in Cheers Centre --- p.285 / Chapter 12.2 --- Getting into the Field --- p.286 / Chapter 12.3 --- Comparison between the CNBF and Cheer Centre: Mode of Rehabilitation --- p.291 / Chapter 12.3.1 --- Major Differences in the Modes of Rehabilitation --- p.291 / Chapter 12.3.2 --- Difference in Goal of Rehabilitation --- p.293 / Chapter 12.3.3 --- Difference in Degree of Intimacy --- p.294 / Chapter 12.4 --- The Basic Format of Counseling Groups --- p.296 / Chapter 12.4.1 --- Themes of Motivational Groups: From Health Appeal to Self-Narrative of Lifestyle --- p.297 / Chapter 12.4.2 --- Themes of Relapse Prevention Group Self Narration and Positive Psychology --- p.299 / Chapter 12.4.3 --- The Important Role of Professional Ex- in Counseling Groups --- p.300 / Chapter 12.5 --- Comparison between the CNBF and Cheer Centre: Organization Practices --- p.301 / Chapter 12.5.1 --- Tight Regulations vs. Loose Regulations --- p.302 / Chapter 12.5.2 --- Surveillance Role vs. Serving Role of Social Workers --- p.303 / Chapter 12.5.3 --- Systematic Training vs. Loose Training of Professional Ex- --- p.305 / Chapter 12.6 --- The Preferred Narrative of Drug Addiction in Cheer Centre --- p.308 / Chapter 12.6.1 --- Health Appeal on Drug Addiction --- p.308 / Chapter 12.6.2 --- Moral Appeal on Drug Addiction --- p.310 / Chapter 12.6.3 --- Drug Addiction as a Lifestyle Problem --- p.311 / Chapter 12.6.4 --- The Identification of Addictive Use as Hitting Bottom Experience --- p.313 / Chapter 12.6.5 --- The Role of Positive Psychology --- p.314 / Chapter 12.7 --- The Resistance and Disorders of Discourse in Cheer Centre --- p.318 / Chapter 12.7.1 --- Resistance from Youth Addicts -- Tactics to Get Rid of Addict Identity --- p.318 / Chapter 12.7.2 --- Contradiction between Medical and Legal Discourses --- p.320 / Chapter 12.7.3 --- Disorders of Discourse: Hedonistic Discourse and Functional Use of Drug --- p.321 / Chapter 12.7.4 --- Ignorance of Marijuana Users -- Incapability of Prodigal Son Returns Home Discourse --- p.323 / Chapter 12.7.5 --- Ignorance of Hitting Bottom Experience --- p.324 / Chapter 12.8 --- Adaptation by Youth Addicts -- Strategic Use of Prodigal Son Returns Home Discourse --- p.325 / Chapter 12.9 --- Conclusion: Prodigal Son Returns Home Discourse in the CNBF and Cheers centre --- p.328 / Chapter Chapter 13: --- Drug Narratives of Youth Drug Addicts in Cheer Centre --- p.332 / Chapter 13.1 --- The Study of Self-Narrative as Part of the Drug Discourse --- p.333 / Chapter 13.2 --- Narrative Inquiry on Youth Drug Addicts’ Life Stories --- p.335 / Chapter 13.2.1 --- Dimensions in the Study of Self Narratives --- p.335 / Chapter 13.2.2 --- A Narrative Model in the Analysis of Drug Stories --- p.338 / Chapter 13.3 --- The Preferred Go Through Narrative of Drug Addiction --- p.340 / Chapter 13.3.1 --- Cases showing the Preferred Go Through Narrative of Drug Addiction --- p.341 / Chapter 13.3.2 --- Important Features of Preferred Go Through Narrative --- p.342 / Chapter 13.3.2.1 --- Capable of Presenting Drug Stories in Temporal Order --- p.343 / Chapter 13.3.2.2 --- Clear Identification of Addiction --- p.344 / Chapter 13.3.2.3 --- Concrete Hitting Bottom Experience --- p.346 / Chapter 13.3.2.4 --- Relating Drug Addiction to Lifestyle Problem --- p.347 / Chapter 13.3.2.5 --- Capable in Narrating Key to Recovery --- p.349 / Chapter 13.3.2.6 --- The Presentation of Stable Abstinent Identity --- p.349 / Chapter 13.4 --- The Habitual and Consumption Story of Drug Use --- p.351 / Chapter 13.4.1 --- Cases showing the Habitual and Consumption Story of Drug Use --- p.353 / Chapter 13.4.2 --- Important Features of the Habitual and Consumption Story --- p.354 / Chapter 13.4.2.1 --- Lack of Explicit Temporal Order in Drug Story --- p.355 / Chapter 13.4.2.2 --- Lack of Identification of Addiction --- p.356 / Chapter 13.4.2.3 --- Incapability to Articulate Hitting Bottom Experience --- p.357 / Chapter 13.4.2.4 --- Drug Use as Personal Consumption but not Lifestyle Problem --- p.358 / Chapter 13.4.2.5 --- Blurred Key to Recovery --- p.360 / Chapter 13.4.2.6 --- Lack of Stable Abstinent Identity --- p.361 / Chapter 13.5 --- The Flexible Prodigal Son Story of Drug Addiction --- p.362 / Chapter 13.5.1 --- Cases showing the Flexible Prodigal Son Story of Drug Addiction --- p.365 / Chapter 13.5.2 --- Important Features of the Flexible Prodigal Son Story --- p.368 / Chapter 13.5.2.1 --- Clear Temporal Order of Drug Story --- p.368 / Chapter 13.5.2.2 --- Clear Identification of Recreational Use to Addictive Use of Drugs --- p.369 / Chapter 13.5.2.3 --- Capability in Articulating the Hitting Bottom Experience --- p.370 / Chapter 13.5.2.4 --- Relating Drug Addiction to Lifestyle Problem --- p.371 / Chapter 13.5.2.5 --- Clear but Diverse Keys to Recovery --- p.372 / Chapter 13.5.2.6 --- Hybrid Abstinence Identity with Past Identity Practices --- p.373 / Chapter 13.6 --- In Struggle: The Ineffective Prodigal Son Story of Drug Addiction --- p.375 / Chapter 13.6.1 --- Cases showing the Ineffective Prodigal Story of Drug Addiction --- p.377 / Chapter 13.6.2 --- Important Features of the Ineffective Prodigal Son Story --- p.380 / Chapter 13.6.2.1 --- Lack of Clear Temporal Order of Drug Story --- p.380 / Chapter 13.6.2.2 --- Identification of Addictive Use of Drugs --- p.382 / Chapter 13.6.2.3 --- Not Concretely Articulating the Hitting Bottom Experience --- p.382 / Chapter 13.6.2.4 --- Implicitly Relate Drug Addiction to Lifestyle Problem --- p.383 / Chapter 13.6.2.5 --- Lack of Concrete Key to Recovery --- p.385 / Chapter 13.6.2.6 --- Suspicion of Self Abstinence Identity --- p.386 / Chapter 13.6.3 --- Key Differences between the Flexible Prodigal Son Story and the Ineffective Prodigal Son Story --- p.387 / Chapter 13.7 --- Conclusion: Discursive Formation of Deviant Identity through the Subject of Prodigal Son --- p.388 / Chapter Chapter 14: --- Conclusion Drug Addiction, Prodigal Son and Normalization of Drug Use --- p.394 / Chapter 14.1 --- Research Summary and Key Findings --- p.395 / Chapter 14.2 --- Answers to Research Questions: --- p.407 / Chapter 14.2.1 --- Answer to Research Question 1 --- p.408 / Chapter 14.2.2 --- Answer to Research Question 2 --- p.409 / Chapter 14.2.3 --- Answer to Research Question 3 --- p.413 / Chapter 14.3 --- Discussions and Implications --- p.414 / Chapter 14.3.1 --- Foucault’s Concept of Disciplinary Power Discursive Control by Prodigal Son Identity --- p.415 / Chapter 14.3.2 --- Goffman’s Concept of Role and Performance the Strategic Use of Prodigal Son as Impression Management --- p.422 / Chapter 14.3.3 --- Theoretical Implication: A Suggested Model of Agency under Mediated Dominant Discourse of Deviant Identity --- p.428 / Chapter 14.3.3.1 --- Suggested Conditions for the Constitution of Mediated Dominant Discourse of Deviant Identity --- p.429 / Chapter 14.3.3.2 --- Suggested Model of Agency under Mediated Dominant Discourse of Deviant Identity --- p.438 / Chapter 14.3.4 --- Social Implications and Limitations of Research --- p.449 / Chapter Appendix I: --- Drug Addiction Models --- p.455 / Chapter Appendix II: --- Major Treatment Modes of Drug Addiction in Hong Kong --- p.459 / Chapter Appendix III: --- Voluntary Residential Rehabilitation Programs in Hong Kong --- p.462 / Chapter Appendix IV: --- Lists and Summary of the selected Hong Kong Anti-drug TV APIs in 1970s, 1980s, 1990s, 2006 and 2008 --- p.464 / Chapter Appendix V: --- Attributions, Solutions and Consequences of Drug Addiction Reported by Informants in Anti-Drug TV News Documentaries --- p.481 / Chapter Appendix V: --- Interview Schedule for the Trainee Informants in the CNBF --- p.485 / Chapter Appendix VII: --- Interview Schedule for the CNBF Mentors --- p.487 / Chapter Appendix VIII: --- Socio-demographic Profile of the CNBF Informants and Interview Report --- p.491 / Chapter Appendix IX: --- Socio-demographic Profile of the Informants in Cheer Centre and Interview Reports --- p.503 / Chapter Appendix X: --- Interview Schedule for the Informants in Cheer Centre --- p.512 / Chapter Appendix XI: --- A Selected Glossary of Local Drug Addicts --- p.513 / Bibliography --- p.516

Purpose of Review: This review aims to (1) conceptualize the complexity of the opioid use disorder epidemic using a conceptual model grounded in the disease continuum and corresponding levels of prevention and (2) summarize a select set of interventions for the prevention and treatment of opioid use disorder. Recent Findings: Epidemiologic data indicate non-medical prescription and illicit opioid use have reached unprecedented levels, fueling an opioid use disorder epidemic in the USA. A problem of this magnitude is rooted in multiple supply- and demand-side drivers, the combined effect of which outweighs current prevention and treatment efforts. Multiple primary, secondary, and tertiary prevention interventions, both evidence-informed and evidence-based, are available to address each point along the disease continuum—non-use, initiation, dependence, addiction, and death. Summary: If interventions grounded in the best available evidence are disseminated and implemented across the disease continuum in a coordinated and collaborative manner, public health systems could be increasingly effective in responding to the epidemic./p>